[1]靳玉娟a,王鹏飞b,王诗男b,等.老年血管性痴呆患者血清ANGPTL4 和sTLT-1 水平表达与其认知功能及预后的相关性研究[J].现代检验医学杂志,2024,39(04):105-109+160.[doi:10.3969/j.issn.1671-7414.2024.04.019]
　JIN Yujuana,WANG Pengfeib,WANG Shinanb,et al.Correlation between Serum Levels of ANGPTL4 and sTLT-1 and Cognitive Function and Prognosis in Elderly Patients with Vascular Dementia[J].Journal of Modern Laboratory Medicine,2024,39(04):105-109+160.[doi:10.3969/j.issn.1671-7414.2024.04.019]
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老年血管性痴呆患者血清ANGPTL4 和sTLT-1 水平表达与其认知功能及预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年04期
页码:
105-109+160
栏目:
论著
出版日期:
2024-07-15

文章信息/Info

Title:
Correlation between Serum Levels of ANGPTL4 and sTLT-1 and Cognitive Function and Prognosis in Elderly Patients with Vascular Dementia
文章编号:
1671-7414（2024）04-105-06
作者:
靳玉娟a; 王鹏飞b; 王诗男b; 陈长英c
（河北燕达医院 a. 急诊医学科；b. 老年医学科；c. 神经内科，河北廊坊 065201）
Author(s):
JIN Yujuana; WANG Pengfeib; WANG Shinanb; CHEN Changyingc
(a. Department of Emergency Medicine； b. Department of Geriatrics Medicine；c. Department of Neurology，Hebei Yanda Hospital，Hebei Langfang 065201，China)
关键词:
血管性痴呆; 血管生成素样蛋白4; 可溶性骨髓细胞样转录因子-1; 认知功能
分类号:
R749.13；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.04.019
文献标志码:
A
摘要:
目的 探讨老年血管性痴呆（vascular dementia, VD）患者血清血管生成素样蛋白4（angiopoietin-like protein 4，ANGPTL4）、可溶性骨髓细胞样转录因子-1（soluble bone marrow cell-like transcription factor-1，sTLT-1）水平表达与其认知功能和预后的相关性研究。方法 选取2020 年6 月～ 2022 年6 月在河北燕达医院收治的92 例老年血管性痴呆患者作为研究组，根据简易精神状态量表（minimum mental state examination，MMSE）评分分为轻度组（n=30）、中度组（n=36）和重度组（n=26），另选取同期健康体检者92 例作为对照组。根据患者预后认知功能障碍情况分为I ～ II 级和III 级；采用ELISA 方法检测各组血清ANGPTL4 和sTLT-1 水平，采用Pearson 和Spearman 法分析血清ANGPTL4，sTLT-1 与MOCA 评分的相关性；采用Logistic 回归分析老年血管性痴呆患者预后分级为III 级的影响因素；绘制受试者工作特征（receiver operating characteristic，ROC）曲线分析血清ANGPTL4 和sTLT-1 水平对老年血管性痴呆患者预后分级为III级的预测价值。结果 研究组血清ANGPTL4（987.57±53.25 pg/ml）水平显著低于对照组（1 108.35±62.13 pg/ml），血清sTLT-1（68.01±5.15 pg/ml）水平显著高于对照组（50.12±4.57 pg/ml)，差异具有统计学意义（t=14.158，24.922，均P ＜ 0.05）。轻度、中度和重度组血清ANGPTL4 水平和MOCA 评分依次降低（F=33.495，66.617），血清sTLT-1水平依次升高（F=66.718），差异具有统计学意义（均P ＜ 0.05）。Pearson 法分析显示，血清ANGPTL4 与sTLT-1 呈负相关（r=-0.621，P ＜ 0.05），Spearman 法分析显示，血清ANGPTL4 与MoCA 评分呈正相关（r=0.545，P ＜ 0.05），sTLT-1 水平与MoCA 评分呈负相关（r=-0.557，P ＜ 0.05）。III 级预后患者血清ANGPTL4（953.45±51.16 pg/ml）水平显著低于I ～ II 级（1 005.76±54.27 pg/mL），血清sTLT-1（73.14±5.40 pg/ml）水平显著高于I ～ II 级（65.28±5.02pg/ml），差异具有统计学意义（t=4.490，6.967，均P ＜ 0.05）。Logistic 回归分析得知，ANGPTL4 低表达[OR（95%CI)：5.089（1.833 ～ 14.129）]，sTLT-1 高表达[OR（95%CI)：4.258（1.739 ～ 10.428）] 均为影响老年血管性痴呆患者预后分级为III 级的危险因素（P ＜ 0.05）。根据ROC 曲线得知，二者联合预测老年血管性痴呆患者预后分级为III 级优于ANGPTL4 和sTLT-1 各自单独预测（Z =2.135，3.268，均P ＜ 0.05）。结论 老年血管性痴呆患者血清ANGPTL4 水平显著降低，sTLT-1 水平显著升高，ANGPTL4 和sTLT-1 与认知功能和预后密切相关。
Abstract:
Objective To investigate the correlation between serum Angiopoietin-like protein 4 (ANGPTL4) and soluble bone marrow cell-like transcription factor-1 (sTLT-1) levels and cognitive function and prognosis in elderly patients with vascular dementia(VD). Methods A total of 92 elderly patients with vascular dementia admitted to Hebei Yanda Hospital from June 2020 to June 2022 were selected as the study group. They were divided into mild（n=30）, moderate（n=36）and severe groups （n=26）according to the minimum mental state examination (MMSE) score, and 92 patients with healthy physical examination during the same period were selected as the control group. According to the prognosis of patients, the cognitive dysfunction was divided into grade I ～ II and grade III. ELISA method was used to detect the levels of serum ANGPTL4 and sTLT-1.Pearson and Spearman methods were used to analyze the correlation between serum ANGPTL4 and sTLT-1 and MOCA scores. Logistic regression analysis was used to analyze the influencing factors of the prognostic grade III of elderly patients with vascular dementia. The receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of serum ANGPTL4 and sTLT-1 levels in the prognostic grade III in elderly patients with vascular dementia. Results The serum ANGPTL4 level (987.57±53.25 pg/ml) in the study group was lower than that in the control group (1 108.35±62.13 pg/ml), and the serum sTLT- 1 (68.01±5.15 pg/ml) level was higher than that in the control group (50.12±4.57 pg/ml), with significant differences (t=14.158，24.922, all P<0.05). Serum ANGPTL4 levels and MOCA scores were decreased sequentially in the mild, moderate and severe groups (F=33.495, 66.617), while serum sTLT-1 level was increased sequentially (F=66.718)，and the differences were statistically significant(all P<0.05), respective. Pearson analysis showed that serum ANGPTL4 was negatively correlated with sTLT-1 (r=-0.621, P<0.05). Spearman analysis showed serum levels of ANGPTL4 and sTLT-1 were positively and negatively correlated with MoCA scores, respectively (r=0.545, -0.557, all P<0.05). The serum ANGPTL4 level (953.45±51.16 pg/ml) in the prognostic patients of grade III was lower than that of grade I ～ II (1 005.76±54.27 pg/ml), and the serum level of sTLT-1 (73.14±5.40 pg/ml) was higher than that of grade I~II (65.28±5.02 pg/ml), with significant differences (t=4.490，6.967, all P<0.05). Logistic regression analysis showed low expression of ANGPTL4 [OR(95%CI): 5.089 (1.833~14.129)] and high expression of sTLT-1 [OR(95%CI)：4.258 (1.739~10.428)] were risk factors affecting the prognosis of elderly patients with vascular dementia (P<0.05). According to the ROC curve, the combined prediction of two for the grade III prognosis of elderly vascular dementia patients was better than the individual prediction of ANGPTL4 and sTLT-1 (Z =2.135，3.268，all P<0.05). Conclusion Serum ANGPTL4 level was decreased but sTLT-1 level was increased in elderly patients with vascular dementia, and ANGPTL4 and sTLT-1 were closely related to cognitive function and prognosis.

参考文献/References:

[1] 刘娟, 崔佳. 血管性痴呆病人血清可溶性凋亡相关因子及其配体、脑源性神经营养因子水平变化[J]. 中西医结合心脑血管病杂志, 2021, 19(11): 1902-1904. LIU Juan, CUI Jia. Changes in serum soluble apoptosis-related factors and their ligands and brainderived neurotrophic factors in patients with vascular dementia[J]. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease, 2021, 19(11): 1902-1904.
[2] SUN Weipeng, LI Minying, LIN Tong, et al. Effect of acupuncture at 3-points for intelligence on vascular dementia: protocol for a systematic review and metaanalysis of randomized controlled trials[J]. Medicine, 2018, 97(42): e12892.
[3] 张冀燕, 程薇, 鲁丽平. 血清sFas, MIF, Klotho 蛋白与血管性痴呆患者认知功能和预后的关系研究[J].检验医学与临床, 2022, 19(24): 3313-3317. ZHANG Jiyan, CHENG Wei, LU Liping. Relationships between serum sFas, MIF, Klotho protein and cognitive function and prognosis in vascular dementia patients[J]. Laboratory Medicine and Clinic, 2022, 19(24): 3313-3317.
[4] 李才信, 马志强, 马云珊, 等. 血清残余脂蛋白胆固醇定量检测对动脉粥样硬化性心血管疾病诊断的临床价值研究[J]. 现代检验医学杂志, 2023, 38(4): 16-21. LI Caixin, MA Zhiqiang, MA Yunshan, et al. Clinical value of quantitative serum residual lipoprotein cholesterol in the diagnosis of atherosclerotic cardiovascular disease[J]. Journal of Modern Laboratory Medicine, 2023, 38(4): 16-21.
[5] FERN?NDEZ-HERNANDO C, SU?REZ Y. ANGPTL4: a multifunctional protein involved in metabolism and vascular homeostasis[J]. Current Opinion in Hematology, 2020, 27(3): 206-213.
[6] 夏瑞雪, 李阔, 王丽轩, 等. 急性脑梗死病人血清ANGPTL4, SIRT1 水平与颈动脉粥样硬化斑块稳定性的关系[J]. 中西医结合心脑血管病杂志, 2021,19(24): 4375-4378. XIA Ruixue, LI Kuo, WANG Lixuan, et al. Relationship between serum ANGPTL4 and SIRT1 levels and carotid atherosclerotic plaque stability in patients with acute cerebral infarction[J]. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease, 2021, 19(24): 4375-4378.
[7] 夏瑜, 康艳飞, 曹敬然, 等. RDW 联合血清CRP，PCT，sTLT-1 与急性脑梗死患者脑梗死体积、神经功能受损程度和预后的关系研究[J]. 现代生物医学进展, 2022, 22(12): 2356-2360. XIA Yu, KANG Yanfei, CAO Jingran, et al. Relationship between RDW combined with serum CRP, PCT, sTLT-1 and cerebral infarction volume, neurological impairment and prognosis in patients with acute cerebral infarction[J]. Progress in Modern Biomedicine, 2022, 22(12): 2356-2360.
[8] 贾建平, 陈生弟. 神经病学[M]. 7 版. 北京: 人民卫生出版社, 2013：217-222. JIA Jianping, CHEN Shengdi. Neurology[M].7th Ed. Beijing: People’s Medical Publishing Hourse Co.LTD, 2013: 217-222.
[9] 刘七十, 李立, 吴引萍, 等. 丁苯酞胶囊联合银杏叶提取物治疗血管性痴呆的疗效及对患者认知功能和生活质量的影响[J]. 海南医学, 2021, 32(22): 2894-2898. LIU Qishi, LI Li, WU Yinping, et al. Efficacy of butylphthalide capsule combined with ginkgo biloba extract in the treatment of vascular dementia and its influence on cognitive function and quality of life of patients[J]. Hainan Medical Journal, 2021, 32(22): 2894-2898.
[10] BATTLE C E, ABDUL-RAHIM A H, SHENKIN S D, et al. Cholinesterase inhibitors for vascular dementia and other vascular cognitive impairments: a network meta-analysis[J]. The Cochrane Database of Systematic Reviews, 2021, 2(2): CD013306.
[11] 袁媛, 党宝齐, 浦建能, 等. 重复经颅磁刺激联合醒脑开窍针法对脑梗死后血管性痴呆患者认知功能及日常生活能力的影响[J]. 现代中西医结合杂志,2020, 29(22): 2470-2473. YUAN Yuan, DANG Baoqi, PU Jianneng, et al. Effects of repeated transcranial magnetic stimulation combined with Xingnao Kaiqiao needling method on cognitive function and daily living ability of patients with vascular dementia after cerebral infarction[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2020, 29(22): 2470-2473.
[12] 周兴栋. 血清ANGPTL4 与冠心病病人PCI 术后支架内再狭窄的相关性分析[J]. 中西医结合心脑血管病杂志, 2022, 20(24): 4535-4537. ZHOU Xingdong. Correlation analysis between serum ANGPTL4 and in-stent restenosis after PCI in patients with coronary heart disease[J]. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease, 2022, 20(24): 4535-4537.
[13] HSIEH H Y, JOU Y C, TUNG C L, et al. Epigenetic silencing of the dual-role signal mediator, ANGPTL4 in tumor tissues and its overexpression in the urothelial carcinoma microenvironment[J]. Oncogene, 2018, 37(5): 673-686.
[14] 李忠强, 林继红, 依仁科. 冠心病患者血清ANGPTL2,ANGPTL4 水平与冠状动脉狭窄程度的关系[J]. 中国医药导报, 2020, 17(2): 109-112. LI Zhongqiang, LIN Jihong, YI Renke. Relationship between the levels of serum ANGPTL 2 and ANGPTL 4 and severity of coronary artery stenosis in patients with coronary heart disease[J]. China Medical Herald, 2020, 17(2): 109-112.
[15] 杨茜, 陈红. ANGPTL4 与糖脂代谢及动脉粥样硬化相关疾病的研究进展[J]. 医学综述, 2018, 24(9):1693-1697. YANG Qian, CHEN Hong. Research progress of glucose and lipid metabolism and atherosclerosis diseases related with ANGPTL4[J]. Medical Recapitulate, 2018, 24(9): 1693-1697.
[16] 黄烈, 邓诗武, 涂富莲, 等. 老年冠心病患者血清S100A12, sRAGE, ANGPTL4 水平与冠状动脉狭窄程度的相关性分析[J]. 标记免疫分析与临床, 2021,28(1): 98-104. HUANG Lie, DENG Shiwu, TU Fulian, et al. The correlation between levels of serum S100A12, sRAGE and ANGPTL4 and the degree of coronary artery stenosis in elderly patients with coronary heart disease[J]. Labeled Immunoassays and Clinical Medicine, 2021, 28(1): 98-104.
[17] CHO D I, AHN M J, CHO H H, et al. ANGPTL4 stabilizes atherosclerotic plaques and modulates the phenotypic transition of vascular smooth muscle cells through KLF4 downregulation[J]. Experimental & Molecular Medicine, 2023, 55(2): 426-442.
[18] 庞睿娟. 急性脑梗死患者血清CD62P, sTLT-1 和ET-1 的表达水平及临床意义探讨[J]. 检验医学与临床, 2019, 16(17): 2484-2486. PANG Ruijuan. Expression levels and significance of serum CD62P, sTLT-1 and ET-1 in patients with acute cerebral infarction[J]. Laboratory Medicine and Clinic, 2019, 16(17): 2484-2486.
[19] SHEN Li, YANG Tianlun, XIA Ke, et al. P-selectin (CD62P) and soluble TREM-like transcript-1 (sTLT-1) are associated with coronary artery disease: a case control study[J]. BMC Cardiovascular Disorders, 2020, 20(1): 387.
[20] MORALES-ORT?Z J, DEAL V, REYES F, et al. Platelet-derived TLT-1 is a prognostic indicator in ALI/ARDS and prevents tissue damage in the lungs in a mouse model[J]. Blood, 2018, 132(23): 2495-2505.
[21] 张文青, 杜菊梅, 颜江, 等. 急性脑梗死患者血清淋巴细胞过氧化小体增殖剂激活型受体γ、内皮素转换酶、可溶性骨髓细胞样转录因子-1 水平变化及意义[J]. 实用医院临床杂志, 2021, 18(5): 130-133. ZHANG Wenqing, DU Jumei, YAN Jiang, et al. Changes and significance of the levels of serum PPARγ, ECE and sTLT-1 in patients with acute cerebral infarction[J]. Practical Journal of Clinical Medicine, 2021, 18(5): 130-133.
[22] 张小鹏. 缺血性脑卒中患者血清HMGB1, sTLT-1 含量与氧化应激反应、内皮损伤程度的相关性[J]. 海南医学院学报, 2017, 23(21): 3021-3024. ZHANG Xiaopeng. The correlation of serum HMGB1 and sTLT-1 contents with oxidative stress response and endothelial injury in patients with ischemic stroke[J]. Journal of Hainan Medical University, 2017, 23(21): 3021-3024.
[23] FU Rong, SONG Xu, SU Dexing, et al. Serum STLT-1 and bilirubin levels in patients with acute coronary syndrome and correlation with prognosis[J]. Experimental and Therapeutic Medicine, 2018, 16(1): 241-245.
[24] 张颖, 张春丽, 李璐, 等. 血管性痴呆患者血清MMP-9,NLRP3, Hcy 水平变化及其与认知、神经功能、预后的关系[J]. 卒中与神经疾病, 2021, 28(1):67-72. ZHANG Ying, ZHANG Chunli, LI Lu, et al. Serum MMP-9, NLRP3 and Hcy level changes in cerebrovascular dementia and their relationship with cognition, nerve function and prognosis[J]. Stroke and Nervous Diseases, 2021, 28(1): 67-72.

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备注/Memo

备注/Memo:
基金项目：廊坊市科学技术研究与发展计划项目（NO：2022013006 ）。
作者简介：靳玉娟（1985-），女，本科，主治医师，研究方向：老年痴呆，E-mail：vjd1pg1@163.com。
更新日期/Last Update: 2024-07-15